Graciela Barrios, an undocumented immigrant with few resources, has long relied on the county health clinic for the advice, medication and tests that have kept her diabetes under control. But next month, Barrios and thousands like her will be on their own, and many more people across the nation face the same fate.

Bowing to recession-related budget pressures, Sacramento County recently took the drastic step of cutting non-emergency health services for illegal immigrants. Contra Costa County, on the east side of San Francisco Bay, will vote on a similar measure Tuesday. Local health systems in other states are facing similar decisions as health officials find themselves trapped between dwindling federal, state and local funding streams and the growing number of newly uninsured who need services.

“The general situation there is being faced by nearly every health department across the country, and if not right now, shortly,” said Robert M. Pestronk, executive director of the National Association of County and City Health Officials, based in Washington.

Data on the cost of health care for unauthorized immigrants is hard to come by, because community clinics and hospitals usually do not ask patients for their immigration status. But the Pew Hispanic Center estimates that about 59 percent of the 11.9 million illegal immigrants living in the United States have no health insurance, making up about 15 percent of the nation’s approximately 47 million uninsured…

In Sacramento County, such cuts initially meant closing three of six clinics. In February, with even less money and more patients lining up, county supervisors and health officials had to decide: close one more clinic, firing up to 40 staffers to save $2.4 million, or cut services to the approximately 4,000 illegal immigrants treated annually.

…Contra Costa County officials are doing the same hard math: if they vote to cut services to the 5,500 illegal immigrants they serve a year, they will save about $6 million.